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comment by JamesTiberiusKirk
JamesTiberiusKirk  ·  3834 days ago  ·  link  ·    ·  parent  ·  post: Should Doctors Work for Hospitals? - Richard Gunderman - The Atlantic

The big secret on non-profit hospitals is that they are nothing of the sort. There's all kinds of waste that goes on in hospitals. Look at how much administrative costs have increased (see table 2 here: http://www.nejm.org/doi/full/10.1056/NEJMsa022033). Notably, this excludes administrative costs related to insurance plans. Given that roughly 2/3 of US hospitals are supposedly non-profit (http://www.aha.org/research/rc/stat-studies/fast-facts.shtml), what would've otherwise been profit is instead squandered in hugely wasteful and totally unnecessary ways.

Non-profit hospitals are just as shameless as the for-profits. They actually have the gall to run development offices dedicated to raising donations while simultaneously charging uninsured patients huge sums of money that they know are totally divorced from reality. They create aesthetically beautiful hospitals at a cost of tens to hundreds of millions of dollars while waxing poetic about the single-digit millions they devote to charity care. They engage in billing practices that are questionable at best and leave the patients with unnecessarily large bills. My institution, for example, knowingly keeps patients in the ICU longer than is medically necessary in order to preserve beds for the particular service we receive patients from (there are a handful of patients on our census that could've left the ICU and gone to the general floor days ago - I'm sure the cost difference between an ICU and standard bed is not inconsequential). They claim medical residents are a financial drain on their system - despite giving only half of the roughly $100k provided to them by the government per year per resident to the residents themselves - failing to take into account that residents, rather than attending physicians, are almost single-handedly responsible for the day-to-day work of delivering healthcare (and, interestingly, pay midlevels that perform the exact same role roughly double what they pay their residents).

In short: fuck hospitals (except, perhaps, St. Jude's in Tennessee and the Shiners Hospitals).





b_b  ·  3834 days ago  ·  link  ·  

Depends on the hospital. There are good ones and bad, just like other sectors. The one for which I work has an annual loss from uncompensated care of around $200,000,000. That's not chump change. Sure they have waste, but they also have a mission. That's not super atypical for a large, urban institution. The ACA does disincentivize doctors from practicing in poor areas however, so to me that's a huge negative.